What is social media? “Social” – refers to instinctual needs humans have to connect with other humans
“Media” – what we use to make connections with other humans
“Social Media” – how we can use technology effectively to reach out & connect with other humans, create a relationship, build trust
Media used for social interaction
2 way communication - interactive dialogue

Social Networks Examples:
Facebook
Twitter
Myspace
LinkedIn
Skype Social networking accounts for 22% of all time spent online in the U.S.
Twitter averages almost 40 million ‘tweets’ per day
1 in 4 people over the age of 65 use social networking sites “There are over 200 active sites using a wide variety of social networking models today.”

Possible situations counselors might encounter Diagnosing clients with internet, gaming, etc addiction
Helping a parent understand how technology use is negatively impacting their child’s life
Providing psycho-education about dangers of online social sites – stalkers, sexual predators, bullies etc
Adults – might be new to technology
Children – might be oblivious to dangers
Client’s personal information available online
Counselor’s information available online
Personal use
Professional use
Dilemma of being friend requested by a client
Using technology in counseling services

What is social networking? “It's the way the 21st century communicates today.”
A social network service is an online service, platform, or site that focuses on building & reflecting social relations among people who share interests &/or activities
Essentially consists of a representation of each user (profile), social links, & other services
Most are web based; interact through internet, email, instant messaging(chatting), or phone applications

Telephone Work phone number
Personal phone number
Texting
Hotlines
Provide free, anonymous and immediate help
Offer information, emotional support, and referrals
234 million people over 13 years old used mobile devices in Dec 2009

Telephone Reduces response time
Increases accessibility
Agencies should have emergency services available 24 hours a day, 7 days a week
Telephone also integral part of traditional counseling
Adjunct to face-to-face work with clients
Few professionals have training in this area though
Client is in complete control of the duration of the conversation
Client can hang up when they want

Suggestions for Telephone Communication with Clients Track more
Tune into nonverbal cues
Appreciate the intimacy of telephone communication
Use your body as you talk
Take notes
Have vital resource information near your telephone
Maintain contact

Internet Michael Feeny (2001) stated that a large number of online counseling and therapy sessions will be taking place every day in the not too distant future
Currently, about 5,000-25,000 online contacts between counselors and clients take place daily

Telephone & Internet Like using a telephone, most internet communication does not involve visual cues, however that may be an advantage
Comfort and privacy of client’s home
Can take whatever time needed to compose messages (email)
Because client isn’t seen, may feel sense of anonymity and be less inhibited and candid

Crisis Most fundamental task – make yourself known as someone who can help in a crisis
In person, in writing, over the phone, or through the internet – making contact with person in crisis is essential step in crisis intervention

Initial session vs Established Relationship How do you think an established relationship would influence efficacy of online or telephone communication with clients?
Rapport already established
Trusting relationship built

Confidentiality Difficult to maintain
People can overhear or accidentally see conversations
How could the information be used?
How do you keep records?
Could a transcript of a session be called into court?
If using a type of “real time” chat or e-mail how do you limit the risk of third party knowledge of an online session
encryption—how much does this limit risk?

Ethical Framework for Use of Social Media Practitioners are mindful that social media activity can blur the boundaries between personal & professional lives
Applicable ethical principles relevant to clinical care & social media:
Confidentiality
Multiple Relationships
Testimonials
Informed Consent
Minimizing Intrusions on Privacy
Initiating Professional Relationships
Documenting and Maintaining Records

ACA Code of Ethics (2005) A.12. Technology Applications
Counselors inform clients of benefits & limitations of using information technology applications in the counseling process
Include but are not limited to computer hardware, software, telephones, Internet, online assessment instruments & other communication devices
When providing technology-assisted distance counseling services, counselors determine that clients are intellectually, emotionally, & physically capable of using the application & the application is appropriate for the needs of the clients
When technology-assisted services are deemed inappropriate, counselors consider delivering services face to face
Counselors ensure that use of technology does not violate laws of any local, state, national, or international entity

Code of Ethics continued… As part of the process of establishing informed consent, counselors do the following:
Address issues related to difficulty of maintaining confidentiality of electronically transmitted communications
Inform clients of all colleagues, supervisors, employees who might have access to electronic transmissions
Urge clients to be aware of all users including family members & fellow employees who have access to any technology clients may use in the counseling process
Use encrypted websites and email communications to help ensure confidentiality
When encryption is not possible, notify clients & limit electronic transmissions to general communications – not client specific
Inform clients if & for how long storage of records maintained
Discuss possibility of technology failure & alternate methods
Provide clients with emergency procedures (calling 911 or crisis hotline) if counselor not available
Discuss time zone differences & cultural or language differences that might impact service delivery
Inform clients when technology assisted distance counseling services not covered by insurance

Scope of Practice Indicates the specific area to which a practitioner may practice
May also define where a practitioner may practice
Understanding boundaries & limitations of one’s specific discipline
Understanding specific laws or ethics within one's own discipline or geographic location
Respect specific laws of potential client’s geographic location
Competence

Training and Supervision of Online Counseling Work Limited course work regarding the specifics of online counseling work to ensure competency and efficacy through online medium
Limited number of Supervisors available with experience in online counseling work to provide appropriate supervision of online counseling work

Client’s Access to Counselor’s Personal Info “Prior to calling or interviewing their potential psychotherapists, consumers are likely to search for the therapists Facebook profile or page, or other social networking profiles” (Zur, 2009)
Through social networks
How much personal information should be available for public view?
Pictures, interests, hobbies, phone #, address, communication with others (Facebook wall, etc)

Digital “Natives” vs Digital “Immigrants” Things to be aware of
Cautions to remind children/teens of
Cautions to remind parents of
Understanding purpose of social networks
Understanding dangers of social networks
Privacy
Cyber-bullying

Ways Social Media will Change Mental Health Care Changing how we communicate & define “relationship”
Professionals will collaborate more – more comfortable communicating via social outlets
Also learn to consult & collaborate more on cases (careful with confidentiality), share research information, & become partners on treatment programs
The stigma & isolation of mental illness could decrease
Online patient advocacy sites allow people to discuss mental health issues with one another – share similar experiences & provide suggestions for coping

Ways Social Media will Change Mental Health Care continued… Allow us to create & provide simple follow up programs & protocols that can be sent out to people daily, weekly, or monthly via email, text, audio, or video
Reminders to take medication, exercise, eat right, go to bed on time, use a journal, etc
Greater ability to create treatment programs that clients want & need
Allows us to listen & discuss with consumers what they would like in terms of service structure & offerings

Overall Disadvantages Techniques difficult to employ through social media
Non-verbal gestures
Confidentiality difficult to maintain
Clients might prefer to remain anonymous
How do you know you are talking to who they say they are?
How do you collect payment from someone you don’t know?
Valid evidence supporting efficacy of cyber-counseling is hard to come by

Things to keep in mind Social media offers valuable tools and resources which can support face to face counseling
If you want to use social media, remember to prepare the client - inform them of appropriate expectations
It is important for each counselor to decide what the personal advantages & disadvantages are of using social media in their practice
Also keep in mind your organization’s policy (if you do not have a private practice)

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